Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 54293 | AZ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.025704 | OH |
NPI | 1033430335 |
---|---|
Provider Name | Dr. Shawn Michael Stevens |
First Address | Phoenix, AZ 85013-4422 |
Second Address | Phoenix, AZ 85013-4422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 25/02/2021 |